skip to main content

Acute gout in CKD — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute Rheumatological and Dermatological EmergenciesAcute gout in CKDSCE Acute Medicine

A 68-year-old man is assessed on the acute medical unit. He has CKD stage 4 and an acutely painful first MTP joint. He takes apixaban and has a history of peptic ulcer bleeding. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Give oral corticosteroid therapy

Give oral corticosteroid therapy is the best answer because oral corticosteroid is often safest when NSAIDs and colchicine are problematic due to renal function and bleeding risk. Arrange same-day ambulatory follow-up is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Crystal arthritis treatment must be individualised to comorbidity.

Reference: NICE NG219